Pain Domains Research Articles

Assessment of oral health-related quality of life and oral side effects of radioactive iodine therapy

ObjectivesTo evaluate the impact of oral health problems on oral health-related quality of life (OHRQoL) among female patients received Radioactive iodine (131I) therapy.Materials and methodsThis unmatched case-control study was conducted on 40 female patients (20 cancer free controls and 20 patients treated with 131I therapy). Data were collected via clinical examination, self reported questionnaire including the Oral Health Impact Profile-14 (OHIP-14), salivary tests, socio-demographic and behavioural characteristics. Data were analyzed using descriptive, bivariate and multivariate statistics.ResultsThere were significant differences in the total number of decayed, missing and filled surfaces, stimulated and unstimulated salivary flow rates, and periodontal indices between the study and control groups in the unadjusted analysis. Age adjusted analysis revealed significant differences in the stimulated and unstimulated salivary flow rates, periodontal indices, physical pain domain scores between groups. No significant differences were observed between groups in the xerostomia severity and OHRQoL. In study group, the score for the OHIP-14 psychological discomfort domain was negatively correlated with both stimulated and unstimulated salivary flow rates. The total OHIP-14 score and its domain scores of physical pain and psychological disability were correlated positively with the severity of xerostomia, but negatively correlated with number of the repeated 131I therapy.ConclusionsDue to xerostomia, patients reported worse OHRQoL in the domains of physical pain, psychological discomfort and disability. They had worse periodontal status and tooth brushing habits than healthy controls.Clinical relevanceThe findings of this study may provide a valuable insight on the oral health problems and needs of target group when planning a a team-based care.

Validity and reliability of the Manchester Oxford Foot Questionnaire (MOXFQ) in one-year postoperative ankle fracture patients—a validation study

BackgroundAnkle fracture patients are a heterogenous group with differences in age, sex, fracture morphology, and treatment provided. With the increased focus on patient-centered treatment, patient-reported outcome measures (PROMs) are increasingly adopted by clinicians to facilitate best clinical practice. The Manchester Oxford Foot Questionnaire (MOXFQ) has demonstrated good measurement properties when used in patients with foot or ankle disease. The PROM has three domains: (1) Pain; (2) Walking/Standing; and (3) Social Interaction. One study found sufficient content validity for the Pain and Walking/Standing domains when used in the evaluation of ankle fracture patients. Another validation study demonstrated acceptable structural validity and reliability for the MOXFQ in ankle fracture patients 12 weeks after injury. The aim of this study is to assess the structural validity and reliability of the Norwegian version of the MOXFQ in the context of an ankle fracture patients one year after surgery and provide patient acceptable symptom state (PASS) estimates.MethodsA pragmatic cross-sectional study design was used to collect the one-year MOXFQ follow-up data from patients surgically treated for an ankle fracture in the period 2017 to 2020 at (Stavanger University Hospital). The structural validity and internal consistency were assessed using confirmatory factor analysis. A separate test-retest study including patients at least one year since ankle surgery was used in the assessment of reliability and measurement error.ResultsA confirmatory factor analysis of the three-factor model of the MOXFQ had a good model fit (TLI 0.94; CFI 0.95; RMSEA 0.094; SRMR 0.039). However, the measurement model demonstrated poor discriminant validity of the three factors. A unidimensional model of the 16 items had worse model fit, while a second-order factor model demonstrated strong factor loadings for a second-order factor. A bi-factor model also revealed a strong general factor but also unique variance in the Pain and Social Interaction domain. The domains had good internal consistency (McDonald’s omega 0.80 to 0.95) and test-retest reliability (ICC 0.80 to 0.92). The standard errors of measurements for the three domains were between 6.5 and 7.5, and 5.5 for the MOXFQ-Index (scale 0 to 100). PASS estimates for the (sub)scales were: Pain 45; Walking/Standing 39; Social Interaction 19; and MOXFQ-Index 34.ConclusionThe MOXFQ with three domains demonstrated sufficient structural validity and reliability when used in the evaluation of a one-year postoperative ankle fracture population. Reporting the scores of the Pain and Walking/Standing domains was best supported.

Pain in idiopathic scoliosis not associated with known genetic variants for pain.

Back pain is common in idiopathic scoliosis. The aim of this study was to study known genetic variants associated with pain in individuals with idiopathic scoliosis. We included 1442 individuals with juvenile or adolescent idiopathic scoliosis from Sweden and Denmark. Single nucleotide variants (SNV) genotyping was performed on 37 SNVs. Pain was assessed using 2 questionnaires. The mean pain domain score on the Scoliosis Research Society 22 revised questionnaire (SRS-22r) ranging between 1 (worst) and 5 (best) was dichotomized into a "back pain group" (score <4) and a "no back pain group" (score ≥4). The EuroQol 5-dimensions (EQ-5D) 3 level pain domain was dichotomized into a "no pain group" and a "pain group." Odds ratios were used to describe the associations. Based on the SRS-22r pain domain scores, 456 individuals (32%) reported back pain. Based on the EQ-5D questionnaire, 813 individuals (56%) reported moderate or extreme pain/discomfort. The odds ratio for the associations between the selected genetic variants and back pain or pain in general as measured with SRS-22r and EQ-5D-3L ranged between 0.88 to 1.17 and 0.86 to 1.16, with P-values ranging between 0.08 to 0.99 and 0.08 to 0.95. This study suggests that known genetic variants associated with pain do not play a significant role in the development of pain in individuals with idiopathic scoliosis.

Mind–body treatments for children with functional gastrointestinal disorders

SUMMARY Paediatric functional gastrointestinal disorders (P-FGIDs) are common, affecting up to 25% of children worldwide. They are characterised by chronic abdominal pain and/or altered bowel habits without an underlying disease pathology. P-FGIDs are often associated with co-occurring anxiety and depression across all ages and treating P-FGIDs may provide an opportunity to develop a young person's wider emotion regulation capacities. Using a fictitious case vignette, we outline the range of psychosocial and biomedical treatments for the disorder and the need for an integrated and holistic approach. We propose that by intervening early and enabling children to be curious about, rather than fearful of, their bodily sensations, clinicians may be able to alter harmful illness trajectories in both pain and psychiatric domains.

Effect of nationwide postoperative rehabilitation at home program after lower extremity surgeries in older and younger people.

A nationwide Rehabilitation at Home Care Pilot Program for patients undergoing lower extremity orthopedic surgeries has been ongoing since 2020. The program was designed to improve clinical outcomes through early mobilization and rehabilitation after discharge. This study aimed to analyze the interim data to assess its effectiveness and suggest improvements, particularly for older patients who are more vulnerable compared to younger patients. We analyzed the data of 872 patients from seven hospitals. Patients were divided into an older-age group (OG) (≥ 60 years) and younger-age group (YG) (< 60 years). The Berg Balance Scale (BBS) and numeric rating scale (NRS) scores for pain were the main outcomes. Participants were categorized into OG (n=801) and YG (n=71). The most common surgeries were knee joint replacement (63.7%) in OG and hip joint replacement in YG (77.5%). It took more days to enroll in the pilot program in OG (4.4 days) than YG (3.2 days). OG showed less improvement in BBS than YG for all surgeries (23.3 vs. 31.9) and hip joint surgery (19.8 vs. 33.5). In patients with hip joint replacement in OG, those with a higher number of comorbidities (≥3) showed less BBS improvement than those with fewer comorbidities (<3). In the pain domain, NRS scores decreased in both groups. The postoperative rehabilitation education program appeared to be effective in improving physical function and reducing pain severity, though the improvement was less obvious in older patients who may require a more comprehensive approach compared to younger patients.

Firearm injury survivors report extreme high risk for poor physical and mental health outcomes early after hospital discharge necessitating multidisciplinary care

BackgroundUp to 20–40% of survivors of any traumatic injury develop post-traumatic stress disorder (PTSD) or depression after injury. Firearm injury survivors may be at even higher risk for adverse outcomes....

Translation, cross-cultural adaptation and psychometric evaluation of the Serbian Ankylosing Spondylitis Quality of Life (ASQoL) Questionnaire (refers to r-axSpA) and its relations with disease activity and functional status indices

ObjectivesTo translate, cross-culturally adapt and validate the Serbian Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, e.g. according to the new nomenclature Radiographic-Axial Spondyloarthritis (r-axSpA), and to relate it to disease activity and functional status domains.MethodsFour stages were accomplished: (1) Bilingual and lay panel for translation and cross-cultural adaptation (2) Cognitive debriefing interviews (assessing the language and cultural equivalence of the concepts used in the Serbian ASQoL translation) for face and content validity (3) Psychometric evaluation: (a) convergent validity by NHP as a comparator scale and (b) known group validity by correlations with disease activity and overall health status and reliability (internal consistency and test-retest reliability) (4) Independent regression analyses for relations between ASQoL and ASDAS, BASDAI, BASFI, Schober’s test, respiratory index and SPARCC were used. The statistical program SPSS (version 21; IBM, Armonk, NY, USA) was used.ResultsThe bilingual panel made a unified version of the translated documents, a lay panel confirmed the clarity of the questionnaire. Cognitive debriefing interviews with 10 patients evaluated the Serbian ASQoL as clear, precise, easy to complete. The psychometric properties with 60 randomly selected patients showed good convergent validity between ASQoL and NHP domains of pain (r = 0.79), emotional reactions (r = 0.78), physical activity (r = 0.77) and energy (r = 0.75). The internal reliability was 0.95 and 0.91 (1st and 2nd administration), respectively, and the test-retest reliability was 0.84. Regression analyses showed highly significant relationships (p < 0.001) between ASQoL and ASDAS (R²=0.403), BASDAI (R²=0.564) and BASFI (R²=0.444).ConclusionThe Serbian ASQoL demonstrated good psychometric properties and significant relationships with disease activity and functional status and is recommended for quality of life assessment in Serbian-speaking ankylosing spondylitis (radiographic axial spondyloarthritis) patients, both in clinical practice and clinical research.

Computerized adaptive testing for PRWHE measurements using domains of pain and motor function.

The Patient-Rated Wrist and Hand Evaluation is an outcome measure for patients with conditions affecting the wrist or hand. We evaluated the structural validity of the Patient-Rated Wrist and Hand Evaluation using psychometric techniques, then developed computerized adaptive testing algorithms. Factor analysis found two health constructs consistent with 'Pain' and 'Motor Function'. Two computerized adaptive tests were developed, which reduced the number of items from five to a median of one ('Pain'), and from 10 to two ('Motor Function'). Both computerized adaptive tests achieved high levels of precision (standard error of measurement <0.3) and similar scores to the full-length measure, demonstrated by Bland-Altman analysis. Dividing the Patient-Rated Wrist and Hand Evaluation into two subscales could reduce the response burden, improve standardization of outcome measurement for clinicians and provide precise insight into patient symptoms.Level of evidence: N/A.

Pain and Physical Function are common core domains across 40 core outcome sets of musculoskeletal conditions: A systematic review.

To determine common domains across existing musculoskeletal COSs. Secondary aims were to assess the development quality of existing musculoskeletal COSs and whether development quality and patient participation was associated with domain selection. A systematic review of musculoskeletal COSs. We searched six databases from inception until December 2023. Studies were included if they reported on the development of a COS in adults with musculoskeletal conditions for any type of intervention. Quality was assessed using the Core Outcome Set-Standards for Development recommendations. Data extracted included scope of the COS, health condition, interventions, and outcome domains. We defined a common core domain when present in >66% of all COSs. Analyses were performed using descriptive statistics. We included 51 studies reporting on 40 COSs, 25 were developed for research settings only, 5 for clinical settings only and 10 for both. We identified 310 domains consisting of 255 mandatory/compulsory/not specified, 45 important, and 10 for further research. Pain (90%) and physical function (88%) were common core domains. COS development quality varied (range: 4 to 11 recommendations met); six COS met all standards. Domain definitions were provided in 13 COSs, 27 included patients or representatives in their development process, while 9 met all recommendations for the consensus process. COSs involving patients were of higher quality (median: 9 vs 5 for those not involving patients). Pain and physical function core domains should be considered for inclusion in all new musculoskeletal COSs. Developers should follow COS development recommendations and include patients or their representatives.

Systematic Review of Pain Assessment Measures Used in Pediatric Acute Lymphoblastic Leukemia

ABSTRACTBackgroundPain is a prevalent, frequent, and often persistent symptom among children with acute lymphoblastic leukemia (ALL). Despite its high prevalence, pain has remained understudied, and no evidence‐based recommendations exist for how best to assess and treat pain in this population. Without proper assessment, clinical efforts to improve pain management in pediatric ALL will be ineffective.AimsTherefore, the purpose of this systematic review is to describe and identify gaps in measurement approaches that have been used to assess pain in pediatric ALL, evaluate the psychometric properties of available pediatric pain measures, and provide recommendations for clinical research and practice.MethodsLiterature searches were performed following Cochrane and PRISMA guidelines for systematic reviews. Domains of pain assessed, measures used to assess pain, measure format, respondent, and timing of pain assessment were extracted from studies that met inclusion criteria. The psychometric properties of included measures were then evaluated. A total of 238 full‐text articles were screened and 123 met inclusion criteria.ResultsMost studies assessed pain using generic health‐related quality of life instruments rather than pain‐specific measures. A total of 39 measures were used across the 123 included studies, and the psychometric properties of the measures varied considerably.ConclusionsRecommendations include a selection of well‐validated pain assessment measures that are currently available and can be used to facilitate best practices in ALL pain assessment. Clinicians and investigators are encouraged to utilize a multidimensional pain assessment approach to inform and enhance pain care in pediatric ALL.

Impact of tooth wear on quality of life of patients attending a tertiary hospital in Lagos, Nigeria

Tooth wear is listed as one of the main oral health problems which affects a major part of the population. It may affect the physical, mental and social well-being of an individual, thereby impacting on the general health and quality of life. This study aimed to determine the impact of tooth wear on quality of life of patients attending a tertiary hospital in Lagos. Methods: 239 consecutive subjects with tooth wear who attended the Dental Centre of the Lagos State University Teaching Hospital Ikeja, Lagos within a period of 3months were recruited. Informed consent was obtained, and an interviewer-administered structured questionnaire was used to collect sociodemography, diet history and tooth brushing techniques. All subjects also completed the oral health impact profile 14 (OHI-14) questionnaire. Basic Erosive Wear Examination (BEWE) index was used to assess tooth wear. The association between tooth wear and OHI-14 was determined. Results: The age range was 18years to 80years with a mean of 56.21±14.3 years. A higher proportion of tooth wear was seen in males (52.3%). The most common BEWE index score was medium, 9-13 (130; 54.4%), followed by high, 14 and above (59; 24.7%) and the least was low, 3-8 (50; 20.9%). The physical pain domain had the highest mean score of 3.11±24 while social disability domain had the least which was 0.8±1.2 Conclusion: The most affected domain was physical pain followed by psychological discomfort and physical disability while the least affected domain was social disability.

Oral health-related quality of life and levels of anxiety and depression in individuals with oral potentially malignant disorders

Objectives: To evaluate oral health-related quality of life and possible correlations with anxiety and depression in patients with oral potentially malignant disorders. Methods: This cross-sectional study was carried out in a reference center for oral lesions in the interior of the state of Bahia from February 2022 to January 2023, using the questionnaires Oral Health Impact Profile-14, Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9. Results: There was a slight change in the oral health-related quality of life of individuals in the sample, with a prevalence of responses to psychological discomfort, psychological incapacity, and physical pain domains. In addition, 39.7% and 17.9% of patients were identified as likely having generalized anxiety and depressive symptoms, respectively. When relating the levels of anxiety and depression with the perception of oral health-related quality of life, a positive correlation was found (p&lt;0.0001). Conclusions: Patients with oral potentially malignant disorders showed a slight change in oral health-related quality of life. However, there was a positive correlation between the perception of oral health-related quality of life and levels of anxiety and depression.

Pelvic Floor Muscle Training vs. Vaginal Vibration Cone Therapy for Postpartum Dyspareunia and Vaginal Laxity.

Background and Objectives: Pelvic floor dysfunction and sexual health issues are common postpartum due to weakened pelvic muscles, significantly impacting women's quality of life (QoL). Pelvic floor muscle training (PFMT) is a widely used approach to address these issues. This study aimed to compare the effectiveness of two rehabilitation methods-vibrating vaginal cones (VCG) and PFMT exercises (CG)-in improving pelvic floor muscle strength, reducing dyspareunia, and enhancing sexual function in postpartum women. Materials and Methods: This 1-year retrospective observational analysis evaluated 57 postpartum women presenting with perineal muscle relaxation and sexual dysfunction. Participants were assessed 3 months postpartum (T0) and after 3 months of therapy (T1) at the Pelvic Floor Rehabilitation Clinic of Santa Chiara Hospital, Pisa. Outcomes were measured using the pubococcygeus (PC) test for pelvic floor strength and the Female Sexual Function Index (FSFI) for sexual function. Results: The results revealed significant improvements in pelvic floor muscle strength and sexual function across both groups. While both interventions effectively reduced dyspareunia, the VCG group demonstrated superior outcomes, with 96.67% of participants reporting no pain compared to 80.95% in the CG. FSFI scores improved significantly in both groups, with greater enhancements in arousal, desire, and pain domains observed in the VCG group (p < 0.01). Vaginal cone therapy also resulted in slightly higher gains in overall pelvic floor strength. Conclusions: These findings suggest that vibrating vaginal cones may be a promising option for postpartum pelvic floor rehabilitation, with potential benefits for improving sexual satisfaction and reducing pain.

ASSESSMENT OF ORAL HEALTHRELATED QUALITY OF LIFE IN PERIODONTITIS

Purpose of the study. Study of the quality of life of patients with periodontitis of varying severity. Material and methods of the study. 200 residents of Baku city with periodontal diseases took part in the study The quality of life indicators were studied according to the Nottingham Health Profile system, which includes the following parameters: vigour, pain, emotional reactions, sleep, social isolation, physical activity and health status. Additionally, a special questionnaire was used for the subjective assessment of oral health, including the following aspects: bleeding gums, breath odour (halitosis), tooth mobility, gum pain, tooth hypersensitivity, changes in tooth position and plaque. Results. The mean score for the general assessment of quality of life (QoL) among patients with mild, moderate, and severe periodontitis was 4.4±0.69, 7.4±1.25, and 23.2±1.791, respectively. The highest score, exceeding 30 points, was observed in patients with severe periodontitis. The most pronounced effects were observed in the domains of pain, physical activity, and health status. The items vitality and social isolation were less affected. The total score for oral health-related quality of life (OHRQoL) as assessed by patients was 3.85±0.192 for mild periodontitis, 5.63±0.190 for moderate periodontitis and 11.43±0.499 for severe periodontitis. Comparatively elevated scores were observed in patients with severe periodontitis. The highest mean scores were observed for items such as bleeding, tooth mobility, tooth hypersensitivity and plaque. Conclusions. As the degree of periodontitis worsened and the QoL worsened also. This was particularly reflected in such indicators as pain, physical activity, health status and sleep. Assessment of oral health-related QoL is necessary to determine the effectiveness of interventions aimed at improving and maintaining health. The results of the self-assessment study can be used to determine patients’ subjective perceptions of the impact of periodontal disease on oral health.

Pediatric SARS-CoV-2 long term outcomes study (PECOS): cross sectional analysis at baseline.

PECOS is an ongoing study aimed to characterize long-term outcomes following pediatric SARS-CoV-2 infection. This is a cross-sectional analysis of infected and uninfected cohorts at baseline. Participants (0-21 years) with laboratory-confirmed SARS-CoV-2 infection were enrolled as infected. Uninfected were defined as individuals without history or laboratory evidence of SARS-CoV-2 infection. Outcome measures included demographics, medical history, review of symptoms, physical exam, cardiopulmonary evaluation and validated psychological and developmental surveys. Primary outcomes were cohort comparisons for abnormalities on all measures. 654 participants (541 infected, 113 uninfected) completed baseline visits by June 30, 2023. Infected participants were more likely to report constitutional (OR: 2.24), HEENT (OR: 3.74); respiratory (OR: 2.41), or gastrointestinal (OR: 2.58) symptoms. Infected had worse scores in domains of Pain, Fatigue, Global Health, Physical and Cognitive functioning, Mobility and Sleep disturbances when compared to uninfected controls using Patient Reported Outcomes. Cardiopulmonary findings were similar among cohorts. The first report of this ongoing longitudinal study demonstrates that infected participants were more likely to report symptoms compared to uninfected controls, which may affect performance and quality of life of these individuals. Longitudinal data will increase understanding of long-term effects of SARS-CoV-2 infection in children. gov Identifier: NCT04830852 IMPACT: This study establishes a large, diverse, prospective, longitudinal, multi-center cohort of children with history of SARS-CoV-2 infection compared to an uninfected cohort to be followed for 3 years. Cross-sectional cohort analysis at study entry showed infected participants were more likely to report constitutional, respiratory, and GI symptoms compared to uninfected controls. Infected participants were more likely to have significantly worse parent-reported performance in 6 of 10 Patient Reported Outcome Measures domains. Continued study of this cohort will help identify clinical sequelae of COVID-19, characterize the immune response to SARS-CoV-2 infection, and identify potential genetic/immunologic factors associated with long-term outcomes.

Topical high concentration oxygen with hyaluronic acid: A safe and effective treatment for vaginal atrophy and sexual function improvement.

Genitourinary syndrome of menopause (GSM) is a condition affecting many postmenopausal women. Among the available treatments, the vaginal natural oxygenation device (VNOD) is a new promising option. To evaluate the safety and the effectiveness of vaginal high concentration (HC) oxygen (O2) and hyaluronic acid (HA) in postmenopausal women with vaginal atrophy (VA). Study 1: Ten subjects received HA and O2 at a concentration of 21% (sham group) and ten at 95% (treatment group). All subjects completed five sessions of VNOD. Evaluations and questionnaires were completed at baseline, before each session and at one-month follow-up: Visual Analogue Scale, Vaginal Health Index (VHI), Vaginal Maturation Value (VMV), Menopause Quality Of Life (MeNQoL), Female sexual function index (FSFI) and Female sexual distress scale (FSDS). Study 2: 52 postmenopausal women with VA completed the same protocol of study 1 with HC O2 and HA. Treatment was well-tolerated. In study 1, in the treatment group we recorded significant improvements in VHI score (p-value 0.001), VMV (p-value 0.005) and in the psychosocial, physical and sexual domains of the MeNQoL compared to sham group. In study 2, all women experienced a significant improvement in VHI (p-value <0.001), FSFI total score (p-value 0.007), desire (p-value 0.004), lubrication (p-value 0.006), satisfaction (p-value 0.042), pain (p-value 0.001) domains, FSDS score (p-value 0.003) and MeNQoL sexual domain (p-value <0.001). The preliminary results of this study suggest that VNOD is a safe and effective treatment for VA in postmenopausal women, and improves sexual function.

Pain is what you think: functional magnetic resonance imaging evidence toward a cognitive and affective approach for pain research

The sensory/discriminative domain of pain is often given more consideration than the cognitive and affective influences that ultimately make pain what it is: a highly subjective experience that is based on an individual's life history and experiences. While many investigations of the underlying mechanisms of pain have focused on solely noxious stimuli, few have compared somatosensory stimuli that cross the boundary from innocuous to noxious. Of those that have, there is little consensus on the similarities and differences in neural signaling across these sensory domains. The purpose of this study was to apply our established network connectivity analyses toward the goal of understanding the neural mechanisms behind sensory, cognitive, and affective responses to noxious and innocuous stimuli. Functional MRI data were collected from 19 healthy women and men that experienced warm and hot thermal stimuli across multiple trials. This is a within-subjects cross-sectional experimental study with repeated measures. Ratings of stimulus intensity and unpleasantness that were collected during each run confirmed significant perceptual differences between the two types of stimuli. Despite this finding, no group differences in network connectivity were found across conditions. When individual differences related to pain ratings were investigated, subtle differences were found in connectivity that could be attributed to sensory and association regions in the innocuous condition, and cognitive, affective, and autonomic regions in the pain condition. These results were reflected in the time-course data for each condition. Overall, signaling mechanisms for innocuous and noxious somatosensation are intricately linked, but pain-specific perception appears to be driven by our psychological and autonomic states.

Health-related Quality of life among patients with Ankylosing Spondylitis and its correlation with disease-related variables. A Cross-Sectional Study in Erbil City

Background and objectives: Ankylosing spondylitis is a chronic, rheumatic, inflammatory disease that basically involves axial skeleton. As a result, functional limitations develop that may negatively affect quality of life. Our aim is to assess the quality-of-life in patients with ankylosing spondylitis and to determine its’ correlation with disease variables including disease activity, functional status, spinal mobility, and bodily pain. Methods: A cross-sectional study enrolled fifty patients with ankylosing spondylitis in the Rizgari teaching hospital was conducted between November 2022 to March 2023. Both short form-36 and ankylosing spondylitis quality of life instruments were used to evaluate Health related quality of life. Bath Disease Activity Index, Bath Functional Index, Bath Metrology Index, and total pain visual analogue scale used to assess disease related variables. Results: fifty patients aged (20-50) years participated, their mean age was (35.4), the majority (80%) were males. The peripheral joints were involved in 42% of these patients. The mean ankylosing spondylitis quality of life score was 8.7 ± (4.6) SD, short form-36 domains of physical role limitation, general health, vitality, and bodily pain had the lowest scores (43.5, 44.6, 45.8, 50.7) respectively. both Bath disease activity index (B = 1.047; p = 0.010) and Bath functional index (B=0.974; p=0.012) were poor predictors of Ankylosing Spondylitis Quality of Life score, while Bath Metrology Index (B = -3.444; p = 0.043) was the main predictor for physical functioning. Conclusion: The health-related Quality of life in participants was significantly impaired. High disease activity, poor functional status and limitation in spinal mobility were recognized as poor predictors of Health-related quality of life.

Social determinants of health and impact on Quality of Life in adolescents during the COVID-19 pandemic in Brazil (2020–2022)

BackgroundThe COVID-19 pandemic has underscored the impact of Social Determinants of Health (SDH) on adolescents' Quality of Life (QoL), especially in vulnerable communities. While most research has focused on adults or general clinical conditions, this study addresses the gap in adolescent-specific COVID-19 impacts, emphasizing SDH’s role in Brazilian youth’s health outcomes.MethodologyThis cross-sectional study analyzed 235 adolescents from 89 cities in a northeastern state of Brazil, registered in the Unified Health System's notification system, with data collected nationally in 2022 and referring to the years 2020, 2021 and 2022. Statistical tests, including the Levene test for variance equality, Student's t-test, and ANOVA with a 95% confidence interval, were used, supplemented by the Games-Howell multiple comparison test. The study found lower scores in vitality and mental health domains. Males showed higher scores across all domains (p < 0.001).ResultsAdolescents aged 10 to 14 scored higher in the vitality domain. Those who engaged in physical activity had better scores in general health, vitality, and mental health domains. Adolescents with sleep difficulties had lower scores in pain, general health, vitality, and mental health domains. Additionally, those living with high-risk individuals had lower scores in vitality and mental health domains.ConclusionSDH related to demographic factors, physical activity, and sleep quality significantly impacted adolescents' QoL, particularly affecting vitality and mental health.

Validation of the Portuguese Version of the Modified Harris Hip Score Questionnaire - HHSmBr.

Objective To validate the Portuguese version of the evaluation instrument modified Harris Hip Score. Methods The modified Harris Hip Score went through a validation process for the Portuguese language. We tested the measurement properties of the Brazilian Portuguese version of the modified Harris Hip Score (HHSmBr) on 100 patients (63% females and 37% males) with different hip conditions. Determination of test-retest reliability occurred in 100 participants after an interval of 7 to 14 days. The Cronbach alpha and intraclass correlation coefficient (ICC) evaluated internal consistency and reliability, respectively. The distribution of questions in different categories assessed the floor/ceiling effect. Patients answered the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) and the Hip Disability and Osteoarthritis Outcome Score (HOOS) questionnaires to validate estimates. Results The internal consistency of the HHSmBr was 0.724 in the test and 0.706 in the retest. Test-retest reliability was excellent (ICC = 0.80). The floor/ceiling effect only occurred in the pain domain, with scores 23.2% and 12.1% in test and retest, respectively. Comparing the HHSmBr with the WOMAC and HOOS scores, the lowest and highest correlation values were -0.466 and -0.906, respectively, indicating a moderate-to-strong correlation. Conclusion Our study showed that the HHSmBr is a valid and reliable hip-specific assessment questionnaire in Portuguese.